CV Pharmacology pt 1

Question 1

BP goal for HTN w/o DM or CKD

Answer 1

> 60 BP goal → 150/90
< 60 BP goal → 140/90

Question 2

BP goal for HTN with DM, without CKD

Answer 2

< 140/90

Question 3

BP goal for HTN with CKD, with or without DM

Answer 3

< 140/90 (initiate ARB and/or ACEi or with another class)

Question 4

what are the 4 initial drugs of choice for HTN?

Answer 4

ACEi
ARB
Thiazide diuretics
CCB

Question 5

what is the biggest AE of HTN meds?

Answer 5

OH

Question 6

what is normal resting cardiac index?

Answer 6

2.6 - 4.2 L/min/m2

Question 7

which drug types increase contractility?

Answer 7

-Digitalis
-B1 agonists
-Phosphodiesterase inhibitors

Question 8

what are examples of B1 agonists?

Answer 8

dopamine and dobutamine

Question 9

what type of drugs are Milrinone and Inamrinone?

Answer 9

Type 3 phosphodiesterase inhibitors

Question 10

what do Type 3 phosphodiesterase inhibitors increase?

Answer 10

-Inotropy and chronotropy (result = vasodilation)
-Inc concentration of cAMP → inc Ca induced Ca release
-Inc intracellular Ca concentrations

Question 11

what do Type 3 phosphodiesterase inhibitors decrease?

Answer 11

Arterial pressure
MAP
Organ perfusion

Question 12

what pulmonary issue are Type 3 phosphodiesterase inhibitors good at managing?

Answer 12

pulmonary HTN

Question 13

what is an example of a PDE5 selective inhibitor?

Answer 13

Sildenafil (Viagra)

Question 14

how does digitalis treat impaired contractility?

Answer 14

-Inc vagal efferent activity to heart and slow conduction velocities
-Dec HR, inc contractility

Question 15

what other pathologies can digitalis be used to treat?

Answer 15

a-fib, atrial tachycardia, HF

Question 16

what 3 things do calcium channel blockers decrease?

Answer 16

Contractility
Energy demands on the heart
CO

Question 17

what is double product?

Answer 17

-An estimate of cardiac O2 use
-DP = HR x SBP

Question 18

T/F: diuretics are often the first line of tx for HTN

Answer 18

false!

Question 19

what are the net effects of ACEi?

Answer 19

-Dec vascular smooth muscle tone
-Inhibit secretion of aldosterone
-Decrease renin production

Question 20

what drugs are used to increase BF?

Answer 20

nitrates

Question 21

MOA of nitroglycerin/isosorbide dinitrate

Answer 21

Dec preload and afterload → dec cardiac work → dec MVO2 (cardiac O2 use)

Question 22

in the context of nitroglycerin, what is more important: dec MVO2 or inc O2 availability?

Answer 22

dec MVO2

Question 23

what is the difference between isosorbide dinitrate and isosorbide-5-mononitrate?

Answer 23

-both are long acting
-Isosorbide Dinitrate is used to tx acute episodes and to prevent onset of angina
-Isosorbide-5-mononitrate is primarily used for prevention, not treatment